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Provider Contracting Executive

Humana

Provider Contracting Executive

Humana

2 Locations

·

On-site

·

Full-time

·

1w ago

Compensation

$94,900 - $130,500

Benefits & Perks

Healthcare

401(k)

Parental Leave

Remote Work

Healthcare

401k

Parental Leave

Remote Work

Required Skills

Network Management

Hospital Contracting

Provider Contracting

Contract Negotiation

Financial Analysis

Project Leadership

Medicare Contracting

Medicaid Contracting

Become a part of our caring community and help us put health first

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

The Provider Contracting Executive negotiates contract terms, payment structures, and reimbursement rates with providers. Establishes and maintains relationships with various provider types. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision. Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Use your skills to make an impact

Required Qualifications

  • 5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
  • 2 or more years of project leadership experience
  • Experience leading complex provider contract negotiations
  • Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development
  • Experience with Medicare and/or Medicaid contracts
  • Excellent written and verbal communication skills and experience presenting to varied audiences
  • Must be located within the State of Georgia

Preferred Qualifications

  • Bachelor's degree
  • Experience with ACO/Risk Contracting
  • Experience with Value Based Contracting

Additional Information

This role is considered "remote/work at home", however, preference will be given to candidates located within the Atlanta region. Local candidates will be required to travel into Humana's Atlanta (Riverwood) office for bi-weekly team meetings and for occasional events.

Work at Home Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$94,900 - $130,500 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits:

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and Center Well healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Humana

Humana

Public

Humana is a major American health insurance company that provides health plans, pharmacy services, and healthcare benefits to individuals, families, and businesses. The company operates Medicare Advantage plans, Medicaid managed care, and commercial health insurance products.

10,001+

Employees

Louisville

Headquarters

Reviews

3.3

5 reviews

Work Life Balance

2.5

Compensation

2.8

Culture

2.0

Career

2.5

Management

1.8

25%

Recommend to a Friend

Pros

Better benefits than competitors

Higher upfront pay

Good for employees with families

Cons

Bonuses for denying medical claims

Micromanaging concerns

High qualifications for low pay rates

Salary Ranges

1,554 data points

Junior/L3

Mid/L4

Senior/L5

Junior/L3 · Analyst

138 reports

$72,426

total / year

Base

$68,392

Stock

-

Bonus

$4,034

$49,940

$105,649

Interview Experience

6 interviews

Difficulty

2.7

/ 5

Duration

14-28 weeks

Offer Rate

33%

Experience

Positive 0%

Neutral 33%

Negative 67%

Interview Process

1

Application Review

2

Recruiter Screen

3

HireVue Assessment

4

Hiring Manager Interview

5

Panel Interview

6

Offer

Common Questions

Behavioral/STAR

Healthcare Industry Knowledge

Past Experience

Culture Fit

Technical Knowledge